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Organization
OZARK ORTHOPAEDICS, P.A.
Active
Organization
OZARK ORTHOPAEDICS, P.A.
Active
Other names
Orthopaedic Clinic, Ltd., OZARK ORTHOPAEDICS
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DAVENPORT (DIRECTOR OF OPERATIONS)
(479) 587-3149
Entity
Organization
Contact information
Practice address
603-2 N PROGRESS AVE STE 600, SILOAM SPRINGS, AR 72761-4610
(479) 524-6188
(479) 444-6942
Mailing address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100726900B
—
OK
Enumeration date
04/25/2013
Last updated
07/06/2020
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